Internal anal sphincter achalasia in chronic functional constipation in children: A myth rather than reality

In brief

This study investigates whether internal anal sphincter achalasia (IASA) in children with chronic functional constipation represents a true pathological entity or simply a functional variant. The research examines children presenting with absent rectoanal inhibitory reflex on manometry but normal ganglion cells on biopsy, questioning the clinical validity of IASA as a distinct diagnosis.

• IASA is defined by absent RAIR on manometry with normal ganglion cells on biopsy, distinguishing it from Hirschsprung disease.
• Study challenges whether IASA is a true pathologic entity or simply a functional variant within the spectrum of chronic constipation.
• Absent RAIR in constipated children with normal rectal biopsy may not warrant a separate diagnostic category from functional constipation.
• Manometric findings alone may be insufficient to diagnose IASA without considering broader clinical and pathophysiologic context.

Written by the GCMD Library team from the article.